Monterrubio-Flores Eric, Ramírez-Villalobos María D, Espinosa-Montero Juan, Hernandez Bernardo, Barquera Simón, Villalobos-Daniel Victor E, Campos-Nonato Ismael
Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
Instituto Nacional de Salud Pública, Centro de Investigación en Sistemas de Salud, Cuernavaca, Morelos, Mexico.
Int J Epidemiol. 2021 May 17;50(2):430-445. doi: 10.1093/ije/dyab008.
People with a previous diagnosis of non-communicable diseases (NCDs) are more likely to develop serious forms of COVID-19 or die. Mexico is the country with the fourth highest fatality rate from SARS-Cov-2, with high mortality in younger adults.
To describe and characterize the association of NCDs with the case-fatality rate (CFR) adjusted by age and sex in Mexican adults with a positive diagnosis for SARS-Cov-2.
We studied Mexican adults aged ≥20 years who tested positive for SARS-Cov-2 during the period from 28 February to 31 July 2020. The CFR was calculated and associations with history of NCDs (number of diseases and combinations), severity indicators and type of institution that treated the patient were explored. The relative risk (RR) of death was estimated using Poisson models and CFR was adjusted using logistic models.
We analysed 406 966 SARS-Cov-2-positive adults. The CFR was 11.2% (13.7% in men and 8.4% in women). The CFR was positively associated with age and number of NCDs (p trend <0.001). The number of NCDs increased the risk of death in younger adults when they presented three or more NCDs compared with those who did not have any NCDs [RR, 46.6; 95% confidence interval (CI), 28.2, 76.9 for women; RR, 16.5; 95% CI, 9.9, 27.3 for men]. Lastly, there was great heterogeneity in the CFR by institution, from 4.6% in private institutions to 18.9% in public institutions.
In younger adults, higher CFRs were associated with the total number of NCDs and some combinations of type 2 diabetes, chronic kidney disease, chronic obstructive pulmonary disease and cardiovascular disease.
先前被诊断患有非传染性疾病（NCD）的人更有可能发展为严重形式的新型冠状病毒肺炎（COVID-19）或死亡。墨西哥是严重急性呼吸综合征冠状病毒2（SARS-CoV-2）致死率第四高的国家，在年轻人中的死亡率很高。
描述并表征非传染性疾病与墨西哥成年SARS-CoV-2阳性患者按年龄和性别调整后的病死率（CFR）之间的关联。
我们研究了2020年2月28日至7月31日期间SARS-CoV-2检测呈阳性的≥20岁墨西哥成年人。计算了病死率，并探讨了其与非传染性疾病史（疾病数量和组合）、严重程度指标以及治疗患者的机构类型之间的关联。使用泊松模型估计死亡相对风险（RR），并使用逻辑模型调整病死率。
我们分析了406966名SARS-CoV-2阳性成年人。病死率为11.2%（男性为13.7%，女性为8.4%）。病死率与年龄和非传染性疾病数量呈正相关（p趋势<0.001）。与没有任何非传染性疾病的人相比，当患有三种或更多非传染性疾病时，非传染性疾病数量增加了年轻人的死亡风险[RR，46.6；95%置信区间（CI），28.2，76.9（女性）；RR，16.5；95%CI，9.9，27.3（男性）]。最后，各机构的病死率存在很大异质性，从私立机构的4.6%到公立机构的18.9%。
在年轻人中，较高的病死率与非传染性疾病总数以及2型糖尿病、慢性肾脏病、慢性阻塞性肺疾病和心血管疾病的某些组合有关。
